By becom­ing informed about the signs to look for in peri­s­tomal skin prob­lems, you have taken the first step towards pre­vent­ing them. Peri­s­tomal skin is the skin around the ostomy stoma. Peo­ple with osto­mys are more prone to skin prob­lems such as rashes, infec­tions caused by mois­ture accu­mu­la­tion, reac­tion to dif­fer­ent glues, and build up of nor­mal fungi. Pre­ven­tion is the key, early detec­tion can catch seri­ous com­pli­ca­tions, and unnec­es­sary discomfort.

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Nor­mal skin around an Ostomy stoma

Nor­mal skin should be intact and clear. To keep skin intact, ensure that the skin is dried well before apply­ing a new pouch­ing sys­tem. Exam­ine skin and stoma before apply­ing new pouch. If there is any itch­ing, burn­ing or leak­age change pouch imme­di­ately. Ensure that stoma size is re-measured periodically.

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Der­mati­tis Inflam­ma­tion to the skin, two com­mon types are irri­tant or aller­gic reaction.

Aller­gic Der­matits is a aller­gic reac­tion to skin bar­rier, tape col­lar, adhe­sive remover or skin prep and paste. Presents with itch­ing, burn­ing, sting­ing and red rash.

Treat­ment

Dis­con­tinue use of adhe­sive remover or skin prep.

Change paste to type with lower alco­hol con­tent such as Colo­plast Strip paste.

Calamine Lotion painted over red area will act as a bar­rier and pre­vent fur­ther irritation.

Sween cream can be used to mois­tur­ize dry red area.

Cor­tate (steroid lotion) can help decrease redness.

If rash or red­ness per­sists longer than 2 weeks con­tact ET or Doctor.

Irri­tant der­mati­tis occurs if the pouch­ing sys­tem has leaked. Presents as weepy sores with pos­si­ble bleed­ing. Causes dis­com­fort. This can occur if there has been leak­age or skin strip­ping by fre­quent pouch removal or remov­ing the bar­rier in a rough manner.

Pre­ven­tion

Remove skin bar­rier slowly.

Dry skin well after cleans­ing area.

Exam­ine skin. Use water only to cleanse area if skin is irritated.

If there has been strip­ping of skin Duo­derm may be used to pro­tect the open area.

Stom­a­h­e­sive Pow­der may also assist to dry weepy areas.

If skin irri­ta­tion per­sists longer than 2 pouch hangs, con­tact ET or Doctor.

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Fol­li­culi­tis is an inflam­ma­tion of the hair fol­li­cles which is caused by removal of hair by when skin bar­rier is removed aggressively.

Pre­ven­tion

Clip or shave hair (Mus­tache trim­mer is effective).

Dust affected area with Nys­tatin (anti­fun­gal pow­der). Use spar­ingly. (Nys­tatin may be pur­chased with­out a prescription.)

Con­tact Doc­tor or ET if con­di­tion per­sists after 2 applications.

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Can­dida Albi­cans (Fun­gal Infection)

Can­dida is nor­mally found in the GI Tract. It is a yeast-like fun­gus that can cause an infec­tion around the stoma. Peo­ple with stomae are prone to Can­dida because the area around the stoma is warm and moist and cov­ered. This infec­tion may spread to the groin as this area may also be moist. Presents as red­ness and itching.

Treat­ment

Nys­tatin pow­der may be sprin­kled on affected area as well as 3M No Sting spray.

Use a cot­ton cover over pouch to keep area dry.

Use hair dryer on low set­ting to dry area as well as cloth cover of pouch.

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If any of the above con­di­tions per­sist longer than 2 pouch changes, con­tact ET or Doctor